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<br />@ <br /> <br />Minnesota Department of Public Safety <br /> <br />Alcohol and Gambling Enforcement <br />444 Cedar Street, Suite 133 <br />S1. Paul, MN 55101-5133 <br />651-201-7501- TIY 651-282-6555 - Fax 651-297-5259 <br /> <br /> <br />iJ 2007 <br /> <br />RENEWAL OF LIQUOR, WINE, CLUB OR 3.2% LICENSES <br />'. .' ,N~;jk#1:~ ~~~or~:#t:~~S20~ IDCud{~~~~bY.MNLiiiuoiCoolr1li'~.(3.2% ~~) <br /> <br />Licensee: Please verify your license information contained below. Make corrections if necessary and sign. City <br />Clerk/County Auditor should submit this signed renewal with completed license and licensee liquor liability for the new license <br />period. City Clerk/County Auditor are also required by M.S. 340A.404 S. 3 to report aDY Hcense <br />cancellatioD. <br /> <br />License Code <br />City/County where license approved. <br /> <br />OFSL <br /> <br />License 1?t:1i.Pd Ending <br />L:enterVl!!e <br /> <br />12/31/20~ <br /> <br />15089 <br /> <br />Centerville Liquor Barrel <br />Licensed Location address <br /> <br />Licensee Name <br />Trade Name <br /> <br />GNAW Inc. <br /> <br />*7093 20th Ave S <br /> <br />City, State, Zip Code <br /> <br />Cente~ville. MN 55038 <br /> <br />Business Phone <br /> <br />651/426-6674 <br />LICENSE FEES: Off Sale $ <br /> <br />On Sale $ <br /> <br />Sunday $ <br /> <br />100.00 0.00 0.00 <br />By signing this reDewal appHcatioD, appUcant certifies that there has beeD DO chaDge iD ownership on the above named <br />licensee. For changes in ownership, the Ucensee named above, or for new licensees, full applications should be used. See <br />back of this application for further information Deeded to complete this renewaL <br /> <br />AnolicaDt's siJ:nature on this renewal confirms the foUowiD,: Failure to report any ofthe followml: will result in fines. <br /> <br />1. Ucensee confirms it has no interest whatsoever, directly or indirectly in any other liquor establishments in <br />Minnesota. If so, give details on back of this application. <br />2. Ucensee confirms that it has never had a liquor license rejected by any city/township/county in the sate of <br />Minnesota. If ever rejected, please give details on the back of this renewal, then sign below. <br />3. Ucensee confirms that for the PlUit five years it has not had a liquor license revoked for any liquor law violation <br />(state or local). If a revocation has occurred, please give details on the back of this renewal, then sign below. <br />4. Ucensee confirms that during the past five years it or its employees have not been convicted of any criminal <br />violations or imposed with any civil penalties. If so, please report on back of this application. <br />5. Licensee confirms that during the past license year, a summons has not been issued under the Liquor Uability <br />Law (Dram Shop) MS 340A.802. If yes, attach a copy of the summons, then sign below. <br />6. Licensee confirms that Workers Compensation insurance is in effect for the full license period. <br /> <br />LiceDsee has attached a Hquor liability insurance certificate tbat corresponds witb the license period iD city/county <br />where license is Issued $100,000 in cash or securities or $100,000 surety bond may be submitted in lieu of liquor liabU- <br />lty. (3.2% liquor IiceDses are exempt ifsales are less thaD $25,000 at on sale, or $50,000 at oft'sale). <br /> <br />licenseesiinahlre~ r-//l/~ DOB 7.;,y.7L ss# 1/7'1 Jl) b/(f'l Dale /b:J,. 7 <br /> <br />(Signature certifies ~ be correct and license bas been approved by CIty/COunty.) <br /> <br />aty nerlr/CQunty AlIdilnr Si21'ature <br /> <br />Date <br /> <br />(Signature certifies that renewal of a liquor, wine or club license has been approved by the city/county as stated above.) <br /> <br /> <br />(Signature certifies licensee or associates have not been cited during the past five years for any stateJ1oca1liquor <br />(criminaUcivil). Report violations on back, then sign here. <br /> <br />PS 9093-05 <br />